On today’s episode, Dr. Karen Nelson is joined by Dr. Dawn Taylor, the manager of our residential treatment facility here at Melrose. Dawn and Karen will discuss when residential care is needed and what a patient can expect if they are admitted.
On today’s episode, Dr. Karen Nelson is joined by Dr. Dawn Taylor, the manager of our residential treatment facility here at Melrose. Dawn and Karen will discuss when residential care is needed and what a patient can expect if they are admitted.
For a transcript of this episode click here.
Dr. Karen Nelson: [00:00:00] Eating disorders thrive in secrecy and shame. It's when we create a safe space for honest conversation that we'll find the opportunity for healing. Hi there, I'm Dr. Karen Nelson, licensed clinical psychologist at Melrose Center, welcoming you to Melrose Heals, a conversation about eating disorders. A podcast designed to explore, discuss, and understand eating disorders and mental health.
On today's episode, I'm joined by Dr. Dawn Taylor, manager of our residential treatment facility here at Melrose. Dawn and I will discuss when residential care is needed and what a prospective patient can expect if they are admitted. Now, before I begin, I invite you to take a deep breath and join me in this space.
Welcome to the podcast, Dawn.
Dr. Dawn Taylor: Thank you so much for having me.
Dr. Karen Nelson: Well, so excited to have you here with me [00:01:00] today. Before we get started, I would love it if you could introduce yourself and tell us about your role here at Melrose.
Dr. Dawn Taylor: I'm Dr. Dawn Taylor, I'm a psychologist and the manager of our inpatient and residential units at Melrose.
Dr. Karen Nelson: We've talked a lot on the podcast about outpatient care and actually many of our patients are treated almost exclusively in the outpatient setting. And a very important part of our program is residential care. And so today we're going to be focusing our attention on inpatient and residential care. And so probably a natural place for you and I to start, Dawn, is for us to give some definitions to our listener. And so when we use that word ‘Inpatient Care,’ or we'll use the term IR, tell us what that means.
Dr. Dawn Taylor: Our Inpatient Care is really a residential setting, except we describe it as intensive residential as one level and then residential as another. And what we really mean by that is [00:02:00] intensive residential is when people are really struggling with medical components. So vitals might be off, they're significantly underweight, heart rate might be low, they would come into our intensive residential. And there they will see the doctor daily. There's a lot of monitoring and supervision, a lot of support for what their needs are. And then there is a transition to what we call a residential unit, where there's a lot more practice. You might go out more into a restaurant or you might go home and practice what you've been learning in those units.
Dr. Karen Nelson: Absolutely. So those two levels, intensive residential and residential, and then since we're in the space of definition, we have these – a couple other offerings. Something that we call PHP: Partial Hospital Program. Tell our listeners, what does that mean?
Dr. Dawn Taylor: Our Partial Hospital Program is really where people come and spend eight hours of their day in our facility. They are practicing meals. There will be groups to support them [00:03:00] back into outpatient – or their life. So they're getting ready to go back to school or back to work. So it's the support they need, but it's a day program versus spending the night with us.
Dr. Karen Nelson: Absolutely. And then the last level of care that we're talking about as far as like a higher level of care, rather than just straight outpatient care, is Intensive Outpatient. And what does that mean?
Dr. Dawn Taylor: So, Intensive Outpatient, people often call it IOP, is three hours a day. You're still really getting the support around a meal or learning skills that are going to help you, again, be successful in, whether it's your career, whether it's your social life, being able to go back to that quality of life and that health that you want to have.
Dr. Karen Nelson: So important. And I think it's, as someone moves through the initial assessment phase, and then also, while they're a patient here at Melrose, we can make recommendations as far as what level of care they need. And so help us know, can someone [00:04:00] start at any level? Or how does that work?
Dr. Dawn Taylor: Yeah, people really can start at any level. And there really is an assessment of using the medical doctor, the therapist that might be doing the assessment, to really help them see what matches for what their needs are. Their quality of life might not be where it is. They might be having trouble at work, or in school, or in social life. They might be spending a lot of hours a day worrying about going out to eat with friends, because their eating disorder voice is so loud. They might recommend something like Partial Hospitalization, where they might start that, but if it's not giving them the results they need, they might step up to residential or an intensive residential. Sometimes, in the assessment, their heart rate might be very low or their lab values might be off and we would recommend immediately to go into more of our medical kind of model care.
Dr. Karen Nelson: So true. And so again, either at initial assessment, your provider is making [00:05:00] that determination and recommendation for you. So tell us about when might intensive residential be the right choice for someone who is struggling with an eating disorder?
Dr. Dawn Taylor: So they might be significantly underweight. They might be using symptoms in a way that really impedes on their life. They might be purging a lot or over-exercising a lot and their energy is low. They're having a hard time going to work, getting up for work, their sleep might be disturbed. Intensive residential would be really used for kind of stopping that, or giving them time and allowing them to learn new skills, to put a plan in place and to start practicing that plan while they're being medically monitored daily, to help them get back to what they need.
Dr. Karen Nelson: The way we describe it to our patients, we call it symptom interruption.
Dr. Dawn Taylor: Correct.
Dr. Karen Nelson: Right. And basically it just means the eating disorder symptoms are there. Maybe I'm restricting, binging, purging, [00:06:00] overexercising, and I need to interrupt that pattern of symptoms. Eating disorders can be challenging to shift all on your own.
Dr. Dawn Taylor: Yeah. And I think that is the amazing part about residential, whether it's intensive residential or the residential side, where you really do get to practice those skills that are going to help. Whether it's symptom interruption, or whether it's restoring weight to the place where your brain can function, your bones are going to be healthy, and you're going to feel good. So it is a great supportive environment to learn new things.
Eating disorders are full of fear, anxiety, shame, and it is a way to really engage in how to overcome that, how to practice that while you're around people who understand eating disorders, who understand what you might be going through. You also will have a group of people who are doing the same thing. And so you can learn through people who have struggled for a while and who've [00:07:00] learned what skills might be helping them. It is such an amazing environment to get a jump start on a process that has been around for a long time.
Dr. Karen Nelson: That's right. Tell us about, if someone is recommended to go into the intensive residential program or residential program. Tell us about the medical care that might be provided or what might that look like.
Dr. Dawn Taylor: They will see a doctor daily. It's usually right away in the morning. They will be checking vitals. They might have labs that they need to understand. If they're in our residential unit, they'll see the doctor still, but maybe not every day. It might be once a week. If there's something they're following medically, it might be twice a week. But the doctor still is very connected to their care.
Dr. Karen Nelson: Absolutely. And so, you know, the care that we provide here at Melrose, is that something that you can get kind of anywhere?
Dr. Dawn Taylor: No.
Dr. Karen Nelson: That's right. No. We're special here. Right?
Dr. Dawn Taylor: Yes. We, it [00:08:00] is actually a very specialized care. Yeah. Lab values, heart rates, how we do refeeding, everything is really specialized and under the lens of how a body responds to symptom interruptions. So changing those patterns or being significantly underweight and helping the body get back to a healthy standard. Our staff will collaborate significantly with the other providers that might be caring for these patients also.
Dr. Karen Nelson: Absolutely. I like that you're identifying, this is specialized care. That this might not be something that I'm going to get at kind of like a regular hospital per se. That the care and treatment for eating disorders is unique and coming to a center where we specialize in that, we're updating our processes using the latest research and understanding. It's just so important.
Dr. Dawn Taylor: It really is. I think what people forget, I think culturally we have an idea of [00:09:00] what an eating disorder is. The unfortunate part is, what we know culturally is not actually true. It's a component, often, so culturally people think eating disorders are significantly underweight, young, white, female. That just isn't true. It can be of any weight, and any culture, and it really does take people who are trained to understand what all behaviors are. So whether they're purging, whether they're over exercising, whether there's lots of rules about what to eat, what not to eat, when to eat. So we need trained eyes on how to help people through this and how to understand what's happening to their body.
Dr. Karen Nelson: So important. I think also, you know, to make mention that our intensive residential and residential program, we're located in St. Louis Park, Minnesota. It's a suburb of Minneapolis. The facility is absolutely gorgeous. It's on this beautiful nature preserve. You know, [00:10:00] as soon as you walk into Melrose, there's this like calming, gentle, compassionate space that's created. It doesn't feel kind of medical or hospital like. And I think that's important for people to know.
Dr. Dawn Taylor: I was in the facility when we first opened it. And since day one, I have been amazed at what this facility offers and the location to what it is. I have run many groups myself and we sit on the back deck when the trees are, the leaves are blowing and the trees are all around us. And the Eagle flew over and –
Dr. Karen Nelson: Stop. That's a postcard, Dawn. Right.
Dr. Dawn Taylor: And so it's. To think about that and to think about how patients can sit on the back deck, or we have so many windows. So even if they're not outside, it overlooks like a pond and we see deer, we see animals. It's really a healing space overall. I do think it's important for people to understand when they come in, we do [00:11:00] try to make it comfortable. Eating disorder treatment is hard. There's a lot of fear. A lot of anxiety and it is a hard day and we do what we can in many ways to have day rooms that have art and games and a time to also play, so to speak. The patients really do need a break from the hard part of every day. So we've done a lot to make it as homey as we can.
Dr. Karen Nelson: That's right.
Dr. Dawn Taylor: Even though people are away from home.
Dr. Karen Nelson: I love that. Well, let's maybe talk about, you know, treatment in residential units or what the goals might be. So, if someone is admitted into the intensive residential program, tell us about what some basic goals might be for someone entering into treatment.
Dr. Dawn Taylor: So, at assessment and when people come in, eating disorders vary. So, people, like I said earlier, could be coming in for symptom interruption. So they might be purging every day, multiple times a day. And their goal would really [00:12:00] be to interrupt that, to find a way to eat regularly and kind of overcome their fear and worry about what that would mean. So their goals might be to interrupt that symptom and how to eat regularly, challenge our anxieties. and kind of come to the other side of that. So another goal that people often have in the intensive residential side is weight restoration. So they've come down, they've come in at a really low weight. There's a lot of fear about eating, about eating regularly, about what kinds of food to eat, and their goals would be to practice regular eating, how to break through some of those rules. They might have a very limited scope of what they are able to eat or willing to eat, and their goal might be to incorporate more foods into their regular eating patterns.
So sometimes it's practicing new foods. Sometimes it would be practicing regular eating. So eating breakfast, lunch and dinner [00:13:00] and three snacks. So that is what a day looks like. So there, there will always be three meals and three snacks and what they're practicing will change. So for someone there might be a fear food about – multiple fear foods, and they'll practice that. They might go on a cafeteria experience and really use the skills that were taught in a group to practice how to overcome that fear for one food.
Dr. Karen Nelson: If it is determined that someone may need to do some weight restoration, how do we decide how much we need to restore?
Dr. Dawn Taylor: It really is a scientific model. It's not just a made up number. The dieticians, the medical doctors, all kind of work collaboratively to get medical records from when people were growing up. What we do know about it is where people have been on their growth curve, often where the eating disorder starts, you can see them fall away from their growth curve. And what the dieticians establish is where would they be on their growth curve today if the eating disorder hadn't interrupted their [00:14:00] normal growth. And so they establish where the weight range should be based on your history of your medical records.
Dr. Karen Nelson: So important. I like that you're acknowledging, it's not a made up number, right?
Dr. Dawn Taylor: Correct.
Dr. Karen Nelson: And we want to be very clear about that. We're using individualized data on each of our patients to assess that.
Dr. Dawn Taylor: Absolutely. And that's so important because where people have been developing healthily, we want to get them back there. That is where your brain works the best. That is where your bones are going to respond and be strong enough to support all the things that people want to do. So where your heart, everything. So it's, it really is a different number for different people based on how they were growing. Since they were born.
Dr. Karen Nelson: That's right. Does everyone need weight restoration?
Dr. Dawn Taylor: No, and I think that's also another really important factor here. Again, culturally what we believe is that anorexia is like the only eating disorder. And the reality is [00:15:00] there's multiple eating disorders. People will come in and maybe they're over-exercising. They might be purging. They might have so many rules that their weight might be where it needs to be, but we got to interrupt all the things that are interfering in their health. So it is not always weight restoration. Sometimes it really is learning how to eat breakfast, lunch and dinner and snacks. Sometimes it really is challenging, how do you not exercise after a meal? So it's all kinds of things that we're working on.
Dr. Karen Nelson: Well, let's maybe talk about that idea, you know, you and I have mentioned this idea of symptom interruption. Let's give our listeners an idea of some skills that they might use.
Dr. Dawn Taylor: So, that is a good question. It's a big question.
Dr. Karen Nelson: It's a giant question. Go, Dawn, go.
Dr. Dawn Taylor: Okay, what do I do? What do we do all day? Anxiety is a really big part of an eating disorder, and learning the skills to help understand your anxiety, where it's coming from, and new things that you can do [00:16:00] to kind of find that place of calm, peace, and not, when we're – when we are in kind of an anxiety mindset, our thoughts are going wild. They are out of control. There's big global thinking that happens. ‘I can't, it will never, this is bad, this is good.’ And what we really want to teach patients, and this is often through groups or your individual appointments, where you really understand how to unravel your thoughts and how to make them more kind of neutral so that you can tolerate the fears that have been created by this eating disorder. Once you've learned to tolerate them and practice that, the fears really do kind of dissipate over time. And people will find that when they were once afraid of eating breakfast, if they've practiced it, used the skills of kind of calming their thoughts, they're not really afraid of breakfast anymore.
Dr. Karen Nelson: So, practical strategies.
Dr. Dawn Taylor: It is [00:17:00] amazing what anxiety, fear can do to your brain and how we can kind of short circuit our brain, so to speak, about feeling like it's actually acting on the anxiety or avoid – but it's avoiding and it makes the anxiety bigger. And so learning how to confront anxiety, to understand that you're going to be okay and to not change course of action where you might be engaging in over-exercise or purging or avoiding the next meal of like. One of the biggest things is confronting it, doing it anyway, which is opposite-action and coming to that other side of like, ‘I am okay.’ Anxiety makes us feel like we're not okay. What we want to learn is, food is safe, and we can do this, and we are okay.
Dr. Karen Nelson: I absolutely love that. It's a beautiful description. Oftentimes, we may get an urge to engage in a symptom, and I want to do it right now. So an example may be using purging as an example. I engage with food, I feel panicky, [00:18:00] right, the anxiety, and then I have this urge to use the symptom. Oftentimes, what we are teaching our patients is how to manage the urge. How long might a patient stay in the intensive residential or residential program?
Dr. Dawn Taylor: This is actually a really hard question to answer. Our average time people stay in intensive residential is two weeks. That being said, because eating disorders are variable, so if someone's coming significantly underweight, that stay might be a lot longer. If someone is having a significant time interrupting purging, for example, that stay might be longer than 10 days or 14 days because we're really working at implementing strategies that, again, help them translate to the next level of care, which might be partial hospitalization or might be outpatient.
Dr. Karen Nelson: I liked how you use the word, you know, when someone [00:19:00] is in intensive residential or the residential program, their day is sprinkled with interactions with their team. Let's maybe you and I talk a little bit about who might be on that team. So give us a little bit of a rundown of who, what providers might someone interact with.
Dr. Dawn Taylor: We are so lucky at Melrose.
Dr. Karen Nelson: Yes.
Dr. Dawn Taylor: We have so many amazing providers, but also so many disciplines and so many areas that we can grow from. So, what we have for sure is a psychologist or a therapist. We have occupational therapy. We have physical therapy. Dieticians, medical doctors, psychiatrists. We have, on our units, so on the residential side of things, if you're inpatient, we would have mental health practitioners. So they are very helpful in kind of the day-to-day stressors, or learning skills, or helping practice skills that you've learned in any number of those providers.
Dr. Karen Nelson: Absolutely. I mean, I think [00:20:00] you just really touched on the kind of collaboration that happens when you know, around different specialties to really give people this care that they so need and deserve. I'll just mention two other specialties that may show up on someone's care team is, we have a chaplain, right?
Dr. Dawn Taylor:
Dr. Karen Nelson: Correct. So for spiritual care and then a music therapist.
Dr. Dawn Taylor: Correct. So that again, someone's day. A day does not look the same every day at Melrose. So you might – what is the same is the three meals and three snacks. And that is primary for their care. So they have that every day. And then, between that, we have time, sometimes it's chaplain or spiritual care, there is music therapy groups, there's skills groups, there's kind of processing strategy groups, but there's also grocery shopping groups. There's outings and practicing, ‘Okay, how am I going to cook?’ If cooking has been something that's gone aside in your, in your real kind of world, [00:21:00] practicing how do we grocery shop? How do I cook? How do I do this outside of here? So we have a whole day, kind of a whole week planned that will be varying every day. We want to support everyone in their eating disorder journey. It is so important that eating disorders across the board impact everyone: men, women, transgender.
Dr. Karen Nelson: That's right. And, and we want to be very clear that there is a space here for you.
Dr. Dawn Taylor: Very clear. There's a space for everyone at Melrose.
Dr. Karen Nelson: That's right. Let's maybe transition and talk about the – if a diagnosis is happening and it's been recommended that the level of care is needed as far as like, intensive residential. What if I'm an adolescent or a teen? Do I go to IR?
Dr. Dawn Taylor: Yeah, we are all ages.
Dr. Karen Nelson: We are all ages.
Dr. Dawn Taylor: So there is a very specific program for our [00:22:00] adolescents, and we do family based therapy, which is evidence backed, and we really try to align with those principles to teach the family what the family needs to learn and then to support the adolescent as they are kind of going through. They have their own day room, they have their own groups, and really it's specific to what they're needing to do in treatment. What I like to say all the time is, no one created this eating disorder. Parents aren't at fault, the kid is not at fault, but everyone has to change. And so parents have a good, a big role in helping support their adolescent to this next stage. So they will be learning and they will have their own sessions, sometimes with their child, but sometimes they'll meet with a dietician alone. Sometimes they meet with a therapist alone to really understand what is the meal plan that's going to support my child's recovery? How do I learn the skills? And so parents are a really important part of their child's care. They spend lots of time [00:23:00]learning too. There's groups for parents. There's lots of questions. What happened? Why? What do I do when? And so there's groups specifically just for the parents to have all the places for those questions.
Dr. Karen Nelson: If someone is nervous about a potential stay in IR, what might you say to them?
Dr. Dawn Taylor: I think the first thing I would say is it's going to be okay. And that it is scary because it's new and, and it's, this has been causing them a lot of pain. And I think showing them around, giving them an understanding that you have all these people around that have been experiencing the same thing or similar things, and kind of reassuring them that they will feel better and that they can feel better. Often people come in, they really aren't aware that they can change and that this can change and that the eating disorder can go away. And reassuring them that things can feel better, you [00:24:00] can feel better, is a really important part. Sometimes it really is just recognizing and kind of letting them be scared or sad and just sitting there with them and being available for them.
Dr. Karen Nelson: Well, I think so too. That place many people talk about: The eating disorder sometimes tells us things are certain when they might not be certain. So it might send us messages that I'll never get better. This will never change. I'll always be this way. And to even create a kernel of hope to say, ‘Hey, It could be different and we'll support you finding your way there.’
Dr. Dawn Taylor: And I think that can be such a powerful thing of the group, because when people first come in, sometimes those first couple groups where they have, where someone's shared what the change has happened for them is such a beacon of light or a beacon of hope for them to see that, ‘Wow. If they could change, so can I.’ And so I think that's the power of the group and the [00:25:00] peers around you, because I do think it's true. The eating disorder, people often start believing that that is them versus kind of this illness. And it's kind of scary to think, ‘I can't change or this is just who I am’ versus an illness that is happening to me.
Dr. Karen Nelson: I tell people all the time, healing happens in connection. The eating disorder often is really isolating. It keeps us hidden and it lives in secrets. And so it can feel really scary to walk into a place where I'm going to be talking about it a lot. I'm confronting it maybe for the first time and assuring people, this is what we do. We just really see you and we will help you get there. Like you're not alone. We were not leaving you alone in that space. We're going to support you in that.
Dr. Dawn Taylor: It's such a place full of people who are hopeful people who can hold hope for you when sometimes people don't have it and really a [00:26:00] place where people do so much healing. And I think when people – even if they've gone to the groups or an individual session and have been too afraid to say maybe more than their name, a week later, they're engaged and seeing and practicing and have really experienced the magic of what just being in a place surrounded by sometimes people holding it for you until you can do it yourself or seeing the small steps that people have made, even when they were scared. So watching someone someone else say something like, ‘I'm so afraid to have my visitor come in and do a meal,’ and then the next day watching that person have success with that. That is inspiring. And so sometimes it is just holding that for someone and letting them kind of witness it before they put their foot in it.
Dr. Karen Nelson: It's perfect. It's so good. If a patient needs more time to solidify their skills to [00:27:00] maybe interrupt symptoms or, you know, kind of solidify recovery-type behavior, we would then recommend residential care? Or tell us how a referral to residential care may occur.
Dr. Dawn Taylor: Sometimes it can be, you know, we've done great with intensive residential and we're ready for that next step. So it's again, staying in the residential care. So it's like, kind of a step down and practicing maybe more in the community. Sometimes, residential can be a step up. So let's say someone's an outpatient and really is struggling making any more progress. So medically they might not be compromised, but they're really struggling to make progress with weight restoration, or maybe they're purging a significant amount, or maybe they just can't stop exercising, and it's really interfering with their quality of life. They might not, they might worry so much about exercising that they're not doing social events, or they're really struggling with [00:28:00] connecting with family. There might be isolating. So stepping up to residential can also be a part of that. Of just making movement on a goal that has been very difficult to break or a routine that has been very difficult to break.
Dr. Karen Nelson: Does it ever happen that someone might repeat treatment in intensive residential or our residential programs?
Dr. Dawn Taylor: So it's a common fear when people are leaving intensive residential, like, ‘I don't ever want to come back,’ and the reality is eating disorders are about a journey and sometimes progress can continue and sometimes it stalls out and sometimes it can get harder again. And repeating a stay or coming back, and sometimes it's different goals, right? So you've learned the goals that you needed for the first step, and sometimes it is coming back to intensive residential to practice or get new routines for new goals and the next step. So sometimes people do repeat their stay or have another stay.
Dr. Karen Nelson: Absolutely. And again, those are [00:29:00] conversations that you're having with your treatment team. You're going to be intimately connected with your therapist, your dietician, your medical doctor. And that's part of our role here at Melrose is to be making those recommendations of how to continue to move you towards recovery.
Dr. Dawn Taylor: Everything is done with intense thought about this person's quality of life and what's getting in your way. And so the medical provider is going to have what they want to see. The therapist is going to really work on, like, what's getting in their way. So we collaborate and really create the best treatment plan for that individual.
Dr. Karen Nelson: I think it's important for us to talk about family and friends in someone's healing journey. How might family or friends either begin to see change or how might they support change when someone's admitted to a higher level of care or intensive residential or a residential program?
Dr. Dawn Taylor: Support people are crucial and I think because eating disorders become so [00:30:00] isolating, not a lot of sharing about what has been going on or what they're struggling with, that sometimes support people don't know. They're often afraid to ask because they don't want to make things worse. What we are really encouraging in a higher level of care, and in all levels of care actually, is to understand, to be there, to come to sessions if they can, if they're invited, and to learn about it, to ask the hard questions. Because that shows that they're there, that they're not alone. It breaks that isolation when maybe the person is too afraid to break it. So they can expect maybe being invited to practice a meal with them. And I always encourage, whether it's a parent, whether it's a spouse, whether it's a best friend to ask, don't be afraid to ask, ‘Hey, I'm seeing this. Are you okay?’ ‘Hey, I've noticed this. What's going on?’ So the more that the person is aware and not afraid, I think the isolation can break.
Dr. Karen Nelson: I [00:31:00] think it's often remarkable when my patients share with me, you know, it's been recommended that they go into IR and they may bring it up with family and friends, how sometimes shocked family and friends are that, ‘I didn't know you were even struggling’ or ‘I was a little worried, but again, I didn't want to upset you, so I didn't bring it up.’
Dr. Dawn Taylor: Yeah, it's remarkable how secretive the eating disorder can become and how protective of the behaviors or how worried they are that the behaviors might be seen, that they hide it from the most loved ones, the closest people to them. And it is shocking, I think, for parents, for spouses, to really see all things that can be encompassed in an eating disorder. We don't understand how exercises are diets, or all those things that become part of our cultural kind of lens of cleanses, [00:32:00] or exercise, or body shape, and people don't really understand that these ingrain right into an eating disorder mindset. So it can be shocking for people to understand or see for the first time.
Dr. Karen Nelson: I think also too, we just know, kind of rates of kind of successful treatment. We know people get better when they have people around them that are supporting them, right?
Dr. Dawn Taylor: Yeah.
Dr. Karen Nelson: I mean, we just know support is really important.
Dr. Dawn Taylor: It's crucial having support people and to support you in all – hold you accountable sometimes, to be with you when things are hard sometimes. Having support people around you is a good predictor of outcomes, actually.
Dr. Karen Nelson: Good point. Good point. Well, and I think too, some of the coaching that I might do with my patients is, how to have those conversations. ‘How do I ask for help? How might I say, it really helps when you eat dinner with me and as I'm leaving [00:33:00] intensive residential and now going home, could you share a meal with me?’ I mean, right? Like those become things that can be really helpful.
Dr. Dawn Taylor: Yeah, this world that we live in and I don't want to be a burden and I want to like do things independently and I am strong. Really we have to break kind of some of those myths, right? Like your mom, your best friend is not going to think you're a burden for asking for help. That is a strong thing to do and recognizing that it takes more strength to ask for help. So it's breaking through some of those challenges and some of those myths that we have. And sometimes we do. We practice. How are we going to do this? What will you say? And sometimes we've called them in session and support this person like, ‘Hey, let's do this together.’ I do absolutely coach a lot of people and let me or let your team help do some of the education. I do think for an individual [00:34:00] going through an eating disorder, sometimes teaching their support people about an eating disorder is more than they have right now because they have to focus on healing themselves. So I really encourage people, like let your psychologist, let your therapist, let the medical doctor teach them about what they need to know. Don't put it all on yourself.
Dr. Karen Nelson: Good point. What would you maybe tell parents or guardians of adolescents that are in IR or in res? Tell us about that.
Dr. Dawn Taylor: I think one of the first things I would love to tell a parent is you're going to hear it's making me worse.
Dr. Karen Nelson: Okay, tell me. It's so important, Dawn.
Dr. Dawn Taylor: Adolescence is a hard time, right? Like, let's just take eating disorders or anything else out of it. Adolescence is a time where they push boundaries, where they are wanting to be independent, and they want to be doing whatever they want to be doing. So adolescence, without anything else, is [00:35:00] hard. They don't want to do what they don't want to do. They don't want to be afraid. They don't want to be stressed. They don't want to be away from friends. They want to be in an environment that they want to be in. So often there is a push, just like in anything else, trying to push to get what they want. It's hard to hear your kids say, ‘I'm having a hard time. This is hard. I don't like it here.’ So adolescents have tactics they use to kind of get parents to align. So one of the first things I'd like to have parents understand is this is hard. It's emotionally hard. It sometimes is challenging beliefs that they have about food, about body, about everything, and that they've been practicing for so long. So I would encourage parents and tell them like, be by their side. Tell them, ‘You can do this. I'm with you. We're going to do this together.’ Giving them kind of vocabulary and [00:36:00] warning that this is a hard path. That they're going to be upset sometimes. And that's okay. And it's part of it. And so helping them. Because I think it's scary for a parent when their kid might be crying and feels like they can't do the next meal or that people don't understand them. That's a really hard place for a parent to be. So I would really want parents to understand that it's safe, that it's hard, that it's emotionally, they have to go through this to get to that other side of anxiety, to get to that other side of fear, and that we would walk parents through that too.
Dr. Karen Nelson: So important. Well, finally, I guess, Dawn, tell me, is there anything that I haven't asked that you'd like to say?
Dr. Dawn Taylor: I think with all my years in treating eating disorders, I think the most important part is really understanding that recovery is possible. And that Melrose is one step into their recovery or [00:37:00]residential or intensive residential. Those are just one step. And they might feel hard and scary, but they're short lived. And that these are just steps to create that kind of quality of life that is waiting for them. That the eating disorder has stolen from them. And I really think Melrose is a place for that journey and can support that journey in a way to get that life back that they're searching for.
Dr. Karen Nelson: It's just so hopeful.
Dr. Dawn Taylor: Yes.
Dr. Karen Nelson: Well, Dawn, I can't thank you enough. You are just a gem and I just appreciate our conversation.
Dr. Dawn Taylor: Thank you for having me.
Dr. Karen Nelson: That's it for today. Thanks for joining me. We've covered a lot, so I encourage you to let it settle and filter in. And as I tell my patients at the end of every session: Take notice, pay attention, and we'll take it as it comes. I'll talk to you next time.
To learn more about Melrose Center, please visit MelroseHeals.com [00:38:00] If you or a loved one are suffering from an eating disorder, we're here to help. Call 9 5 2 9 9 3 6 2 0 0 to schedule an appointment and begin the journey towards healing and recovery.
Melrose Heals: A Conversation About Eating Disorders, was made possible by generous donations to the Park Nicollet Foundation